The present application has the overall purpose of delineating specific effects of maternal cocaine and cocaine/polydrug use on pregnancy, the neonate, and the child. The proposal is a 5 year plan to expand the data base regarding the effects of cocaine on pregnancy and the neonate in order to allow more discrete analyses of cocaine and polydrug use patterns and to build on the present cohort of infants to allow longitudinal evaluation of infant and child growth and development through preschool and school age. The specific aims of the project are: 1) To evaluate the polydrug patterns of cocaine use in pregnancy and the differential effects of these patterns of use on pregnancy outcome. 2) To evaluate medical outcome of the neonate exposed to cocaine in utero in relationship to patterns of polydrug use. 3) To evaluate long-term growth and development outcome of infants exposed to cocaine in utero in relationship to patterns of cocaine use. Analysis of outcome will be based on 3 major groups of subjects: Group 1: Pregnant women who are dependent on cocaine and enrolled in our program before 20 weeks gestation/ Group 2: Pregnant women who are polydrug, noncocaine-using women enrolled prior to 20 weeks gestation. Group 3: A comparison group composed of drug-free women who receive prenatal care and delivery through our program at Prentice Women's Hospital. Groups will be matched as closely as possible on maternal variables (ethnic background, socioeconomic status, prenatal care, nutrition, educational level, intelligence, cigarette smoking, parity and age). Data analysis through univariate and multivariate analyses will compare pregnancy outcome and the growth and development course of the neonate and infant as affected by the type and extent of maternal cocaine use.